A Sea Change / A Change in Seeing
We are witnessing a paradigm shift in approaches to psychological and psychiatric suffering, one in which we’re moving away from mechanistic models to more humanistic and humane ones—models that see our connectedness as central to our well-being. Acceptance Commitment Therapy, Mentalization-Based Treatment, Open Dialogue, Internal Family Systems treatment, Intensive Emotion-Focused therapy, the attention to trauma, and the rebirth of an interest in attachments, integrative medicine and mind/body orientations: These models appreciate human beings as infinitely connected, both socially and to the natural world around us. And as we increasingly appreciate the brain and mind as organs of connection, dependent on both natural and social events in our environments, we begin to recognize that any coercive act on our part holds real potential for damage, and that our best work is conducted in collaboration with those who come to us for help.
We can see the outlines of this new paradigm in the treatment of addiction as a new framework emerges based on psychotherapeutic values, a non-judgmental curiosity about why a person might engage in seemingly self-destructive behavior, a belief that a person is making the best choices they can when they use, a respect for the autonomy of the individual, and a firm belief that lasting change never happens through confrontation or coercion. These paradigmal cracks in the disease model for addiction represent the chance for greater creativity in treatment approach, broader treatment choice, and a new freedom in deciding how to handle substances in one’s life. Cracks in the disease model also potentially mean a decrease in stigma, and a much more nuanced view of the use of substances. It fractures a cookie-cutter approach to the use of substances and the engagement in other habits, allowing for care, if desired, to be truly individualized.
As this paradigm shift in the treatment of psychiatric and addictive issues occurs before our eyes, we can also detect a meeting of these once seemingly separate experiences and approaches, as our care of a person’s psychological suffering is no longer bifurcated by the grand categories of either mental health or addiction recovery.
A renaissance in humanistic values, a re-emergence of the importance of attachment, and a return to the body and the earth: The paradigm shift in care is less the birth of something new, than the powerful resurgence of saplings of thought constrained by the pavement of traditional medical approaches. Yet as these paradigms push upward, something new is also occurring: They now have science on their side.
The Shifting the Paradigm conferences aim to bring these new changes in thinking and evidence-based knowledge to the forefront, with the humble goal of aiding in the emergence of this new paradigm.